José F. Figueroa (
Ingrid T. Katz, Harvard University and Brigham and Women's Hospital.
Health Aff (Millwood). 2022 Apr;41(4):581-588. doi: 10.1377/hlthaff.2021.01793.
An increasingly older population of people with HIV raises concerns about how HIV may influence care for Medicare patients. We therefore sought to determine the extent to which HIV influences additional spending on and use of mental health and medical care among Medicare beneficiaries and, importantly, whether treatment with antiretroviral therapy may reduce this additional spending. Using 2016 Medicare claims, we compared risk-adjusted spending and utilization for Medicare beneficiaries with and without HIV, as well as subgroups of people receiving antiretroviral therapy (ART). Compared to beneficiaries without HIV, those with HIV receiving ART incurred 220.6 percent more spending, mostly driven by ART spending, whereas those with HIV not receiving ART incurred 95.4 percent more spending. Among beneficiaries with HIV, those receiving more months of ART had lower spending on treatment for other chronic conditions relative to those receiving fewer months of ART in a dose-response manner. Beneficiaries with HIV not receiving ART incurred the highest spending related to infections, mental health disorders, and other medical conditions compared to beneficiaries in other HIV subgroups receiving ART for various numbers of months. Our findings suggest that ART may be associated with Medicare Parts A and B savings, but ART adherence and the high prices of HIV drugs in Part D need to be addressed.
人口老龄化加剧,艾滋病毒感染者数量增加,这引发了人们对艾滋病毒可能如何影响医疗保险患者护理的担忧。因此,我们试图确定艾滋病毒在多大程度上影响医疗保险受益人的心理健康和医疗保健的额外支出,并重要的是,抗逆转录病毒疗法的治疗是否可能减少这种额外支出。我们使用 2016 年医疗保险索赔数据,比较了有和没有艾滋病毒的医疗保险受益人的风险调整后支出和使用情况,以及接受抗逆转录病毒治疗(ART)的亚组人群。与没有艾滋病毒的受益人群相比,接受 ART 的艾滋病毒感染者的支出增加了 220.6%,这主要是由于 ART 支出所致,而未接受 ART 的艾滋病毒感染者的支出增加了 95.4%。在感染艾滋病毒的受益人群中,接受更多个月 ART 治疗的人相对于接受较少个月 ART 治疗的人,其治疗其他慢性疾病的支出较低,呈现出剂量反应关系。与接受不同数量月份 ART 治疗的其他艾滋病毒亚组的受益人群相比,未接受 ART 治疗的艾滋病毒感染者在感染、心理健康障碍和其他医疗条件方面的支出最高。我们的研究结果表明,ART 可能与医疗保险 A 部分和 B 部分的节省有关,但需要解决 ART 依从性和 D 部分艾滋病毒药物的高价格问题。